RTI International, Social, Statistical, and Environmental Sciences, Washington, DC.
National Network of Public Health Institutes, Research and Evaluation, Washington, DC.
Am J Clin Pathol. 2019 Jan 1;151(1):18-28. doi: 10.1093/ajcp/aqy123.
To evaluate the effectiveness of anemia management and audit with feedback practices in reducing overuse of RBC transfusion.
This review follows the Centers for Disease Control and Prevention's Laboratory Medicine Best Practice Systematic Review (A-6) method. We searched the literature and solicited unpublished studies on practices to reduce overuse of RBC transfusions as measured by reductions in units transfused and proportion of patients transfused.
Thirteen studies on preoperative anemia management and three studies on audit feedback practices met inclusion criteria. Strength of evidence was high to moderate for reducing the number of units and proportion of patients transfused.
Preoperative anemia management reduces the proportion of patients transfused and units of RBCs transfused. Audit with feedback across cases, physicians, and/or service areas, as part of a continuous quality improvement practice, reduces the proportion of patients and units of RBCs transfused.
评估贫血管理和审核反馈实践在减少红细胞输注过度使用方面的效果。
本综述遵循疾病控制和预防中心的实验室医学最佳实践系统评价（A-6）方法。我们搜索了文献，并征集了关于减少红细胞输注过度使用的实践的未发表研究，其衡量标准是输注单位和输注患者比例的降低。
有 13 项关于术前贫血管理的研究和 3 项关于审核反馈实践的研究符合纳入标准。证据强度为高到中度，可降低输血患者的比例和输血量。
术前贫血管理可降低输血患者的比例和红细胞单位的输血量。审核反馈作为持续质量改进实践的一部分，跨病例、医生和/或服务区域进行，可降低输血患者和红细胞单位的比例。
